Hepatitis C

The U.S. Food and Drug Association this week approved AbbVie's Viekira Pak for people with genotype 1 chronic hepatitis C, including patients with compensated cirrhosis. The regimen -- formerly known as "3D" -- consists of the HCV NS3/4A protease inhibitor paritaprevir, a ritonavir booster, and the NS5A inhibitor ombitasvir in a once-daily coformulation, taken with the twice-daily non-nucleoside HCV NS5B polymerase inhibitor dasabuvir.

Chronic hepatitis C patients with advanced liver fibrosis or cirrhosis who achieve sustained virological response to treatment have a life expectancy matching that of the general population, according to findings from a retrospective study published in the November 12 Journal of the American Medical Association. Those who were not cured, however, had significantly reduced survival.

Age cohort screening for hepatitis C virus (HCV) identified 4 times as many people as prevailing screening protocols and can be "feasibly implemented," according to research presented at the American Association for the Study of Liver Diseases (AASLD) Liver Meeting last month in Boston.

An estimated 813,000 people with diagnosed hepatitis C in the U.S. have undergone liver disease staging and meet the "highest" or "high" priority criteria for immediate treatment, according to an analysis presented at the American Association for the Study of Liver Diseases (AASLD) Liver Meeting last month in Boston. The number would be even higher if taking into account undiagnosed individuals and prisoners and others excluded from household surveys.

Nearly one-third of chronic hepatitis C patients with liver cirrhosis and 12% with advanced fibrosis progressed to decompensation within 5 years, and 23% and 11%, respectively, died, according to a study presented at the American Association for the Study of Liver Diseases (AASLD) Liver Meetinglast month in Boston. These findings underscore the urgent need for treatment for such individuals.

A variety of interferon-free regimens containing the direct-acting antivirals sofosbuvir (Sovaldi), simeprevir (Olysio), and daclatasvir (Daklinza) led to high sustained virological response rates, often improved liver function, and were generally safe and reasonably well-tolerated by liver transplant recipients with hepatitis C recurrence, one of the most difficult populations to treat, according to several presentations at the American Association for the Study of Liver Diseases (AASLD) Liver Meeting this month in Boston.

Difficult-to-treat hepatitis C patients with liver cirrhosis who were not cured with a prior course of therapy with first-generation HCV protease inhibitors had a sustained virological response rate of 97% when retreated with sofosbuvir/ledipasvir (Harvoni) for 24 weeks, researchers reported at the American Association for the Study of Liver Diseases (AASLD) Liver Meeting last month in Boston. Sofosbuvir/ledipasvir also worked worked well for people previously treated with other sofosbuvir-containing regimens.

An interferon-free regimen of sofosbuvir plus ledipasvir (Harvoni) taken with ribavirin for 12 or 24 weeks led to sustained virological response in nearly all HCV genotype 1patients with fibrosis or less-advanced liver cirrhosis, researchers reported at the American Association for the Study of Liver Diseases (AASLD) Liver Meeting this month in Boston. Response rates fell for people with more severe cirrhosis and signs of liver decompensation, but still a majority were cured.